A big way of life for rural Mexican American adolescent men and caregivers
Almost half (49.5%) of a primarily Mexican American adolescent population who sought care at a rural health clinic were identified as overweight or obese in a retrospective data analysis. More males than females were classified as overweight or obese. A follow-up pilot study was conducted to explore conceptualization of weight for rural Mexican American adolescent males and a person they named as influencing their health. The research question is: What is the meaning of body weight for Mexican American male adolescents who live in a rural area?
Background
Evidence consistently suggests that the prevalence of obesity has increased among Mexican American adolescents, with higher rates observed in rural versus urban populations. Efficacious interventions to reduce BMI and inclusion of environmental influence in minorities and in males are lacking.
Methods
A convenience sample was recruited during routine visits of participants to a rural health clinic. Participants were asked open-ended questions about what body weight meant to them during 1 hour interviews. Interviews were recorded, transcribed and compared to audio-tapes for accuracy and clarification of context clues. Three investigators experienced in qualitative analysis used content analysis as described by Hsieh and Shannon (2005) to retrospectively analyze transcripts. Data management and integration of analysis was facilitated by use of NVivo. Rigor was addressed by developing consensus between investigators in initial and re-examination of codes and categories and inclusion of memos to create a decision trail.
Results
Fifteen Mexican American adolescent males (12 to 18 years of age) and fourteen individuals these young men identified as influential people (IP) in their lives (32 to 63 years of age; 12 mothers, one father, and one grandmother) were recruited. Participants expressed one meaning of weight to them through sharing norms around being ‘big’.
Young men and IPs reported having a big family, protecting family members from feeling bad in being named ‘big as in overweight’ and feeling powerful in being ‘big’ or having ‘nice, big biceps’.
Being big was described within the context of understanding expected dietary and activity practices with limited resources to implement these practices. Males dropped out of sports due to cost or poor school performance, IPs reported being limited to join training programs or eat ‘healthy foods’ due to cost, geographic distance, and limited amounts of time. Participants shared expectations of how patterns of being big were a way of life for them.
Implications
Interventions targeted at individuals in this rural, Mexican American community are not effective in addressing expected cultural norms. Family support and community support is evident and must be considered with regards to food intake, exercise, norms and scripts. These are community assets that must form the basis of interventions.